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Hyperuricemia is associated with acute kidney injury and all‐cause mortality in hospitalized patients
ABSTRACT Aim Hyperuricemia is a risk factor for high morbidity and mortality in several diseases. However, the relationship between uric acid (UA) and the risk of acute kidney injury (AKI) and mortality remain unresolved in hospitalized patients. Methods Data from 18 444 hospitalized patients were r...
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| Published in: | Nephrology (Carlton, Vic.) Vic.), 2019-07, Vol.24 (7), p.718-724 |
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| container_title | Nephrology (Carlton, Vic.) |
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| creator | Kang, Min Woo Chin, Ho Jun Joo, Kwon‐Wook Na, Ki Young Kim, Sejoong Han, Seung Seok |
| description | ABSTRACT
Aim
Hyperuricemia is a risk factor for high morbidity and mortality in several diseases. However, the relationship between uric acid (UA) and the risk of acute kidney injury (AKI) and mortality remain unresolved in hospitalized patients.
Methods
Data from 18 444 hospitalized patients were retrospectively reviewed. The odds ratio (OR) for AKI and the hazard ratio (HR) for all‐cause mortality were calculated based on the UA quartiles after adjustment for multiple variables. All analyses were performed after stratification by sex.
Results
The fourth quartile group (male, UA > 6.7 mg/dL; female, UA > 5.4 mg/dL) showed a higher risk of AKI compared with the first quartile group (male, UA |
| doi_str_mv | 10.1111/nep.13559 |
| format | article |
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Aim
Hyperuricemia is a risk factor for high morbidity and mortality in several diseases. However, the relationship between uric acid (UA) and the risk of acute kidney injury (AKI) and mortality remain unresolved in hospitalized patients.
Methods
Data from 18 444 hospitalized patients were retrospectively reviewed. The odds ratio (OR) for AKI and the hazard ratio (HR) for all‐cause mortality were calculated based on the UA quartiles after adjustment for multiple variables. All analyses were performed after stratification by sex.
Results
The fourth quartile group (male, UA > 6.7 mg/dL; female, UA > 5.4 mg/dL) showed a higher risk of AKI compared with the first quartile group (male, UA < 4.5 mg/dL; female, UA < 3.6 mg/dL), with the following OR: 3.2 (2.55–4.10) in males (P < 0.001); and 3.1 (2.40–4.19) in females (P < 0.001). There were more patients who did not recover from AKI in the fourth quartile compared with the first quartile, with the following OR: 2.0 (1.32–3.04) in males (P = 0.001) and 2.4 (1.43–3.96) in females (P = 0.001). The fourth quartile group had a higher risk of all‐cause mortality compared with the first quartile group, with the following HR: 1.4 (1.20–1.58) in males (P < 0.001) and 1.2 (1.03–1.46) in females (P = 0.019). The in‐hospital mortality risk was also higher in the fourth quartile compared with the first quartile, which was significant only in males (OR, 2.1 (1.33–3.31) (P = 0.002)).
Conclusion
Hyperuricemia increases the risks of AKI and all‐cause mortality in hospitalized patients.
Summary at a Glance
The present study revealed that patients with a high serum uric acid level had a higher risk of AKI compared with those with a low uric acid level. A high uric acid level was also associated with the risk of non‐recovery from AKI. These findings raise a possible further study about the dose‐response relationship (in particular, the non‐linear relationship) between serum uric acid and outcomes.</description><identifier>ISSN: 1320-5358</identifier><identifier>EISSN: 1440-1797</identifier><identifier>DOI: 10.1111/nep.13559</identifier><identifier>PMID: 30644622</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>acute kidney injury ; Acute Kidney Injury - etiology ; Acute Kidney Injury - mortality ; Adult ; Aged ; Female ; Females ; Hospital Mortality ; Humans ; Hyperuricemia ; Hyperuricemia - complications ; Kidneys ; Male ; Males ; Middle Aged ; Morbidity ; Mortality ; Retrospective Studies ; Risk factors ; survival ; Uric acid ; Uric Acid - blood</subject><ispartof>Nephrology (Carlton, Vic.), 2019-07, Vol.24 (7), p.718-724</ispartof><rights>2019 Asian Pacific Society of Nephrology</rights><rights>2019 Asian Pacific Society of Nephrology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-34cf7766f4495cd96ccf0b804d5a3c681257fc8f59758af4ff33ac4df73831593</citedby><cites>FETCH-LOGICAL-c3539-34cf7766f4495cd96ccf0b804d5a3c681257fc8f59758af4ff33ac4df73831593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30644622$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kang, Min Woo</creatorcontrib><creatorcontrib>Chin, Ho Jun</creatorcontrib><creatorcontrib>Joo, Kwon‐Wook</creatorcontrib><creatorcontrib>Na, Ki Young</creatorcontrib><creatorcontrib>Kim, Sejoong</creatorcontrib><creatorcontrib>Han, Seung Seok</creatorcontrib><title>Hyperuricemia is associated with acute kidney injury and all‐cause mortality in hospitalized patients</title><title>Nephrology (Carlton, Vic.)</title><addtitle>Nephrology (Carlton)</addtitle><description>ABSTRACT
Aim
Hyperuricemia is a risk factor for high morbidity and mortality in several diseases. However, the relationship between uric acid (UA) and the risk of acute kidney injury (AKI) and mortality remain unresolved in hospitalized patients.
Methods
Data from 18 444 hospitalized patients were retrospectively reviewed. The odds ratio (OR) for AKI and the hazard ratio (HR) for all‐cause mortality were calculated based on the UA quartiles after adjustment for multiple variables. All analyses were performed after stratification by sex.
Results
The fourth quartile group (male, UA > 6.7 mg/dL; female, UA > 5.4 mg/dL) showed a higher risk of AKI compared with the first quartile group (male, UA < 4.5 mg/dL; female, UA < 3.6 mg/dL), with the following OR: 3.2 (2.55–4.10) in males (P < 0.001); and 3.1 (2.40–4.19) in females (P < 0.001). There were more patients who did not recover from AKI in the fourth quartile compared with the first quartile, with the following OR: 2.0 (1.32–3.04) in males (P = 0.001) and 2.4 (1.43–3.96) in females (P = 0.001). The fourth quartile group had a higher risk of all‐cause mortality compared with the first quartile group, with the following HR: 1.4 (1.20–1.58) in males (P < 0.001) and 1.2 (1.03–1.46) in females (P = 0.019). The in‐hospital mortality risk was also higher in the fourth quartile compared with the first quartile, which was significant only in males (OR, 2.1 (1.33–3.31) (P = 0.002)).
Conclusion
Hyperuricemia increases the risks of AKI and all‐cause mortality in hospitalized patients.
Summary at a Glance
The present study revealed that patients with a high serum uric acid level had a higher risk of AKI compared with those with a low uric acid level. A high uric acid level was also associated with the risk of non‐recovery from AKI. These findings raise a possible further study about the dose‐response relationship (in particular, the non‐linear relationship) between serum uric acid and outcomes.</description><subject>acute kidney injury</subject><subject>Acute Kidney Injury - etiology</subject><subject>Acute Kidney Injury - mortality</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Females</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Hyperuricemia</subject><subject>Hyperuricemia - complications</subject><subject>Kidneys</subject><subject>Male</subject><subject>Males</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Retrospective Studies</subject><subject>Risk factors</subject><subject>survival</subject><subject>Uric acid</subject><subject>Uric Acid - blood</subject><issn>1320-5358</issn><issn>1440-1797</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNp1kMtOxCAUQInROL4W_oAhcaOLzkCB0i7NxFdi1IWuCUNBGfsSSkxd-Ql-o18iddSFiWyA5OTk3gPAPkZTHM-s0d0UE8aKNbCFKUUJ5gVfj2-SooQRlk_AtvdLhDBPM7wJJgRllGZpugUeLoZOu-Cs0rWV0HoovW-Vlb0u4YvtH6FUodfwyZaNHqBtlsENUDYllFX18fauZPAa1q3rZWX7EYCPre_s-H2Nik72Vje93wUbRlZe733fO-D-7PRufpFc3Zxfzk-uEkUYKRJCleE8ywylBVNlkSll0CJHtGSSqCzHKeNG5YYVnOXSUGMIkYqWhpOcYFaQHXC08naufQ7a96K2Xumqko1ugxdpTEPi8nxED_-gyza4Jk4n0pRihrOojNTxilKu9d5pIzpna-kGgZEY64tYX3zVj-zBtzEsal3-kj-5IzBbAS-20sP_JnF9ertSfgLchZAh</recordid><startdate>201907</startdate><enddate>201907</enddate><creator>Kang, Min Woo</creator><creator>Chin, Ho Jun</creator><creator>Joo, Kwon‐Wook</creator><creator>Na, Ki Young</creator><creator>Kim, Sejoong</creator><creator>Han, Seung Seok</creator><general>John Wiley & Sons Australia, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7X8</scope></search><sort><creationdate>201907</creationdate><title>Hyperuricemia is associated with acute kidney injury and all‐cause mortality in hospitalized patients</title><author>Kang, Min Woo ; Chin, Ho Jun ; Joo, Kwon‐Wook ; Na, Ki Young ; Kim, Sejoong ; Han, Seung Seok</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-34cf7766f4495cd96ccf0b804d5a3c681257fc8f59758af4ff33ac4df73831593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>acute kidney injury</topic><topic>Acute Kidney Injury - etiology</topic><topic>Acute Kidney Injury - mortality</topic><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Females</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Hyperuricemia</topic><topic>Hyperuricemia - complications</topic><topic>Kidneys</topic><topic>Male</topic><topic>Males</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Retrospective Studies</topic><topic>Risk factors</topic><topic>survival</topic><topic>Uric acid</topic><topic>Uric Acid - blood</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kang, Min Woo</creatorcontrib><creatorcontrib>Chin, Ho Jun</creatorcontrib><creatorcontrib>Joo, Kwon‐Wook</creatorcontrib><creatorcontrib>Na, Ki Young</creatorcontrib><creatorcontrib>Kim, Sejoong</creatorcontrib><creatorcontrib>Han, Seung Seok</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Nephrology (Carlton, Vic.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kang, Min Woo</au><au>Chin, Ho Jun</au><au>Joo, Kwon‐Wook</au><au>Na, Ki Young</au><au>Kim, Sejoong</au><au>Han, Seung Seok</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hyperuricemia is associated with acute kidney injury and all‐cause mortality in hospitalized patients</atitle><jtitle>Nephrology (Carlton, Vic.)</jtitle><addtitle>Nephrology (Carlton)</addtitle><date>2019-07</date><risdate>2019</risdate><volume>24</volume><issue>7</issue><spage>718</spage><epage>724</epage><pages>718-724</pages><issn>1320-5358</issn><eissn>1440-1797</eissn><abstract>ABSTRACT
Aim
Hyperuricemia is a risk factor for high morbidity and mortality in several diseases. However, the relationship between uric acid (UA) and the risk of acute kidney injury (AKI) and mortality remain unresolved in hospitalized patients.
Methods
Data from 18 444 hospitalized patients were retrospectively reviewed. The odds ratio (OR) for AKI and the hazard ratio (HR) for all‐cause mortality were calculated based on the UA quartiles after adjustment for multiple variables. All analyses were performed after stratification by sex.
Results
The fourth quartile group (male, UA > 6.7 mg/dL; female, UA > 5.4 mg/dL) showed a higher risk of AKI compared with the first quartile group (male, UA < 4.5 mg/dL; female, UA < 3.6 mg/dL), with the following OR: 3.2 (2.55–4.10) in males (P < 0.001); and 3.1 (2.40–4.19) in females (P < 0.001). There were more patients who did not recover from AKI in the fourth quartile compared with the first quartile, with the following OR: 2.0 (1.32–3.04) in males (P = 0.001) and 2.4 (1.43–3.96) in females (P = 0.001). The fourth quartile group had a higher risk of all‐cause mortality compared with the first quartile group, with the following HR: 1.4 (1.20–1.58) in males (P < 0.001) and 1.2 (1.03–1.46) in females (P = 0.019). The in‐hospital mortality risk was also higher in the fourth quartile compared with the first quartile, which was significant only in males (OR, 2.1 (1.33–3.31) (P = 0.002)).
Conclusion
Hyperuricemia increases the risks of AKI and all‐cause mortality in hospitalized patients.
Summary at a Glance
The present study revealed that patients with a high serum uric acid level had a higher risk of AKI compared with those with a low uric acid level. A high uric acid level was also associated with the risk of non‐recovery from AKI. These findings raise a possible further study about the dose‐response relationship (in particular, the non‐linear relationship) between serum uric acid and outcomes.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>30644622</pmid><doi>10.1111/nep.13559</doi><tpages>7</tpages></addata></record> |
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| ispartof | Nephrology (Carlton, Vic.), 2019-07, Vol.24 (7), p.718-724 |
| issn | 1320-5358 1440-1797 |
| language | eng |
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| source | Wiley |
| subjects | acute kidney injury Acute Kidney Injury - etiology Acute Kidney Injury - mortality Adult Aged Female Females Hospital Mortality Humans Hyperuricemia Hyperuricemia - complications Kidneys Male Males Middle Aged Morbidity Mortality Retrospective Studies Risk factors survival Uric acid Uric Acid - blood |
| title | Hyperuricemia is associated with acute kidney injury and all‐cause mortality in hospitalized patients |
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